:: Permanent Teeth :: What
can damage my child's teeth? :: Tooth Decay
:: Dental Erosion How
can I protect my child's teeth? :: Going to
the dentist :: Diet :: Toothbrushing
Disclosure Tablet Instructions :: Toothpaste
:: Fluoride Supplements :: Fissure
This is a Government initiative operating throughout Scotland to:
- improve the oral health of pre school children
- provide help and advice to parents and carers
- apply flouride varnish to provide protection to milk teeth
Monica McArthur and Lynn Whiting are our Childsmile nurses.
Further information is available on the childsmile website (www.child-smile.org.uk)
Children usually have 20 milk (or deciduous) teeth. They start
to grow through the gums (erupt) at about six months old. Most children
have all 20 teeth by the age of two or three.
Milk teeth have an important part to play in the development of
the permanent teeth, so it is very important to look after them.
teeth usually start to erupt at the age of six. Adults have up to
32 permanent teeth. Most of these will erupt by the age of 13. However,
wisdom teeth - those at the very back of the mouth - often don't
erupt until the early to mid-twenties, if at all.
Permanent teeth press on the roots of the milk teeth. The roots
dissolve until the milk teeth fall out. This is called exfoliation
and happens between seven and 13 years old.
If permanent teeth are damaged or need to be removed, there will
not be another set of natural teeth to replace them.
What can damage my child's teeth?
Many children fall over and bump their teeth accidentally. This
is usually unavoidable and you should take them to the nearest dentist
or Accident and Emergency department for treatment.
However, tooth decay (dental caries) and dental erosion are two
common causes of damage to children's teeth that can be avoided.
Our mouths are full of bacteria that build up on the teeth in a
sticky layer (plaque). These bacteria digest some of the sugar in
our food and drinks, making acids that can weaken the tooth enamel
(enamel is a hard coating on teeth which helps protect them).
Frequent sugar in the diet combined with insufficient toothbrushing
mean that the acids from the bacteria stay in contact with the teeth
for long periods of time, resulting in tooth decay.
Untreated decay will eventually reach the centre of the tooth and
can result in an infection or toothache.
Dental erosion is the gradual wearing away of the enamel on teeth
(enamel is a hard coating on teeth which helps protect them). It
is caused by acid attacking the surfaces of the teeth, but this
time the acids are not made by bacteria. Instead, the acids usually
come from drinks such as fruit juices, fizzy drinks and squashes
- even the sugar-free varieties.
These drinks are so popular that over half of all five year olds
in the UK have significant dental erosion.
Dental erosion can result in sensitivity and pain. Although the
enamel doesn't grow back it doesn't usually need treatment, although
in severe cases your dentist may protect eroded teeth with a filling.
How can I protect my child's teeth?
There are a number of things that you can do to reduce your child's
risk of tooth decay and dental erosion.
Some useful tips include:
- Take your child to the dentist regularly
- Restrict sugary or acidic food and drinks in their diet
- Encourage regular toothbrushing
- Take advice from your dentist about protective treatments such
as fluoride supplements and fissure sealants (See Fissure sealants)
These tips are discussed in more detail below.
Going to the Dentist
a good idea to take your child when you go for your own routine
dental check-ups, even when they are too young to have teeth. This
helps them to become familiar with the people and the surroundings
at the dental surgery.
Your dentist will look in your child's mouth in a fairly informal
way. This allows your dentist to count how many teeth have erupted
and spot any early signs of decay. Quick, painless check-ups like
this help to encourage good co-operation when your child is older.
Your dentist will recommend check-ups at intervals suitable for
your child. Children usually need dental visits more frequently
than adults. This is because milk teeth are smaller and have thinner
enamel, so decay can spread very quickly. Frequent check-ups help
your dentist to treat decay early, before it causes toothache.
Most parents know that reducing sugar in the diet is the best way
to prevent tooth decay. What many don't realise, though, is that
it is how often their child eats sugar - rather than how much -
that is important. Eating sugary food and drinks frequently is the
main cause of tooth decay.
Small sugary snacks taken often = serious decay risk.
E.g. you’re much better to have a packet of milky buttons
all at once rather than a milky button every hour which is a disaster
waiting to happen.
Similarly, it is the frequency of acidic food and drinks - rather
than the amount - that affects tooth erosion. Consuming acidic drinks
frequently is the main cause of tooth erosion.
To protect your child's teeth against decay and erosion, try to
keep squashes, fizzy drinks, natural fruit juices, sweets and cakes
to a minimum. It is especially important to avoid sugary food and
drinks as snacks between meals or before bedtime.
Fruit, vegetables, cheese and milk are all healthier snacks because
they contain natural sugars. These are much less likely to cause
decay. You can help to protect against erosion by finishing a meal
with an alkaline food such as milk or cheese. This will neutralise
the acid in your child's mouth.
Plain water doesn't cause tooth decay or erosion. Some children
find it hard to drink water if they usually have sweeter drinks,
but they will get used to it in time.
should start cleaning your child's teeth as soon as they come through
the gums. Toothbrushes specifically for babies are available. It
is important to try and make toothbrushing a regular activity, after
breakfast and before bedtime, so that it becomes part of your child's
As your child gets older you can teach them how to brush their
own teeth, using a gentle, circular motion and fluoride toothpaste.
Make sure that they understand that they have to clean every tooth.
Give them plenty of encouragement and praise.
You should supervise your child while they brush their teeth. Once
they are about seven years old - or can write legibly - they can
start to brush their teeth on their own, but check how well they
are doing every few days.
Disclosing tablets are small pills that, if chewed for 30 seconds,
turn plaque a bright colour - usually pink. This can help you show
your child any areas they have missed.
DISCLOSING TABLET INSTRUCTIONS
These tablets help you clean your teeth. They do this by showing
where the plaque is on your teeth. If plaque is left on teeth it
causes tooth decay and gum disease. Use the tablets
once a week, on a Friday, so a stained mouth at school isn't a problem
the next day.
The first four Fridays, the tablets show where the teeth need
to be cleaned:
Chew half a tablet in the evening just before
Gently rinse out and inspect the teeth in good
The dark stain shows the areas of plaque
Clean all the surfaces well but the dark areas
need special attention
The next four Fridays, the tablets show where the teeth have not
been cleaned properly:
Carefully brush the teeth as normal
Chew half a tablet after toothbrushing
Gently rinse and inspect the teeth in good lighting
Any dark stain shows areas that have not been cleaned
Clean the teeth again to remove any dark stain
Most toothpaste contains a mineral called fluoride that has been
proven to protect teeth against decay. Fluoride is also added to
the water supply in some parts of the country. In these areas, tooth
decay has been significantly reduced.
use of fluoride has caused some controversy and a great deal of
research has been done to find out if it is safe. The scientific
opinion is that fluoridation does not affect general health. However,
excessive fluoride in young children can result in a mottled appearance
on their permanent teeth (dental fluorosis).
The amount of fluoride in different brands of toothpaste varies.
This amount is measured in "ppmF" (parts per million fluoride).
This is printed on the side of the tube or box. Most toothpastes
are about 1000 to 1500ppmF. Some children's toothpastes are much
lower and may not be strong enough for children who are more vulnerable
to decay. Your dentist will recommend a toothpaste for your child.
If your child is less than two years old, only use a smear of
toothpaste. Then, use an amount about the size of a small pea until
they are seven years old. You must make sure that they spit the
toothpaste out after brushing. However, fluoride needs to be in
contact with the teeth in order to have an effect, so you shouldn't
ask your child to rinse their mouth out with water after toothbrushing.
If your area doesn't have fluoridated water, or your child's teeth
are particularly vulnerable, your dentist may recommend extra fluoride
in the form of tablets, drops or mouthwashes.
Some children have very deep fissures (crevices) in their permanent
back teeth. These can be difficult to keep clean. These fissures
can be sealed with a resin film to protect the surface from decay.
Fissure sealants are quick and painless to apply. The dentist
cleans the tooth with a special acid, then washes and dries it.
The resin is then painted onto the tooth and hardened with a bright,
Fissure sealants can last for several years but regular visits
to the dentist are needed to check that they have not worn through.
Children with fissure sealants still need to brush their teeth with